Abstract
Pregnant women with cyanotic cardiac defects have a high percentage of abortuses and infants small for gestational age. The primary aim of this study was to determine the effect of maternal hypoxemia, as measured by arterial blood gas tensions, on fetal and placental development, neonatal adaptation, and subsequent growth and development. 19 women with right-to-left shunts were studied and 21 of the 30 pregnancies resulted in live births. 11 of these infants were small-for-dates, all born to women who had no surgery or only palliative surgery over 10 years ago. Mothers with total correction of these shunts delivered infants of normal size. Urinary estriol excretion during pregnancy was studied in 6 patients; low urinary estriol levels and low arterial blood oxygen tensions (PO2 < 60 mm Hg) were associated with low birth weight of the infants. Placental size was larger than expected on the basis of birth weight, Blood O2 affinity and red cell 2,3-diphosphoglycerate (DPG) were studied in 2 cyanotic women and in their infants at birth. Blood O2 affinity was significantly decreased and DPG markedly increased in both mothers; the same changes, although to a lesser degree, were observed in their infants, indicating intrauterine adaptation to hypoxia. The postnatal growth and development of all small infants have equalled or exceeded the normal standards.
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Whittemore, R., Anderson, G., Orzalesi, M. et al. The effects of maternal hypoxemia on fetal and infant development. Pediatr Res 5, 426 (1971). https://doi.org/10.1203/00006450-197108000-00229
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DOI: https://doi.org/10.1203/00006450-197108000-00229